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EPIDEMIC CHOLERA 



ft* P0fe 



THEIR RESPECTIVE RESULTS; 



WITH 



DIRECTIONS FOR PREVENTION; AND WHAT TO DO 

IN CASES OF SUDDEN EMERGENCY. 



By JOHN F. GEARY, M.D. 



" Look towards the Eaft ; behold, he offers himself to your view ! 
His indefatigable hand is armed with a terrible scythe, under which fall 
succeffively all generations. On one or his wings are painted war, pefti- 
lence, famine, fhipwreck, and conflagration, with the other sad accidents 
which every inftant furnifh him with a new prey. On his other wing 
are to be seen young phyiicians taking their doctor's degree in the pres- 
ence of Death, who inverts them with the cap, after they hav^e sworn 
never to dispense medicine otherwise than according to the present 
practice." — Le Sage, in Asmodeus, Chap. xm. 



SAN FRANCISCO: 
H. H. BANCROFT & COMPANY. 

1866. 



V 



n 



Entered according to Act of Congress, A.D. 1866, 

By JOHN F. GEARY, 

In the Clerk's Office of the District Court of the United States for the Northern District 

of California. 



EPIDEMIC CHOLERA: 



MODES OF TREATMENT, THEIR RESPECTIVE RESULTS, 

ETC., ETC. 



INTRODUCTION. 

As the following pages are designed for popular 
information, it is not my intention to enter on the 
discussion of the nature, or pathology, of Cholera. 
To the general reader it would he useless ; and all 
well-informed medical men know that on this point, 
as on many others, "doctors differ." Their differences, 
however, as to the nature of any given disease, do 
not so much concern the public as the practical, and, 
to them, vital question— How it should be dealt with 
when it appears ? 

How it may be relieved, or cured 1 In a word— 
" What will they do with it ?" No one needs be told 
that Epidemic Cholera has at different periods ap- 
peared in every quarter of the globe ; that it has made 
its way from continent to continent, from city to city ; 
spreading terror and dismay among the people and 
strewing its passage with death. Nor has the fact 
that medical men — the honored guardians of health 
and life — have been almost powerless in their efforts 



to arrest its progress or rescue its victims, proved the 
least element in increasing the public consternation. 
We have now, however, the advantage of past experi- 
ence to guide us for the future ; and it is the part of 
wisdom and humanity to learn and to teach the costly 
lessons left us by Epidemic Cholera. To feel conscious 
of our weakness in past efforts may become the found- 
ation for future strength. 

In its earlier visitations this plague had only the 
heavy-armed battalions of the Old, or Allopathic 
School of Medicine to oppose it. In later invasions 
it has been met by a comparatively small body of 
light artillery, a ready and willing auxiliary in every 
conflict to the larger and older body of veterans. I 
refer to what is now known throughout the world as 
the Homoeopathic, or New School of Medicine. I 
regret to be obliged to observe here, that, instead of 
being hailed with a shout of triumph and a hearty 
cheer of welcome, they were met with derisive laugh- 
ter, and with haughty insolence ordered to quit the 
field ! How they merited this reception, and how 
well the original contending party was able to carry 
on the war alone, it is the object of these pages to 
to prove. 

The relation of these two Schools to each other, 
their present position before the world, what each has 
accomplished in the different Cholera Epidemics dur- 
ing which they have labored side by side, are matters 
of vast importance to the people of this city and to 



the inhabitants of this coast. " Dead men tell no 
tales," it may be said ; but it is well the living can ; 
and so the past efforts of each, as attested beyond a 
doubt, remain with us now, and should be our guide 
when the new danger threatens, or when the enemy 
reaches our coast. 

Who is not interested in the important questions — 
Is the Cholera approaching 1 
How shall we prevent it ? 
What can doctors do for us ? 
What doctors can do most, and best ? 
What can we do for ourselves in the dead of 

night, before any doctor can be found ? 
How, by some ready and simple domestic appli- 
ance, shall we ward off, or weaken the first 
stroke of an enemy whose second blow is 
death ? 
The importance of these questions to the community 
in which I reside and practice my profession, is my 
apology for attempting to answer them. If any 
further were necessary, I could find it in the fact 
that, so far as I am aware, the School of Medicine to 
which I have the honor to belong has not yet on this 
coast claimed that public consideration, or found 
that open fearless advocacy which are its due; and 
which it is now receiving throughout the world. I 
seek not to draw invidious contrasts between the 
failure of one School or the success of another : I 
shall let each party plead its own cause in its own 



6 

words — by its own figures and facts — and let all who 
are capable of drawing conclusions from legitimate 
premises judge. Let them decide whether it is, or is 
not worth the while of any one who has devoted him- 
self to a profession, the object of which is the saving 
of life and the preservation of health, to stand for a 
time alone, to bear some social and professional dis- 
advantages in his advocacy of that branch which he 
has felt and proved to be beneficent and hopeful — an 
inprovement on the prevailing system — and which 
years of experience have demonstrated to be the 
safest and best, when administering to the sick, and 
when skill and experience give force to mild and fitly 
chosen remedies* 



CHAPTER I. 



ALLOPATHY AND ITS RESULTS. 



The combined and collective experience of the pre- 
vailing, or dominant School of Medicine — -known as the 
Allopathic School — from the first appearance of cholera 
(supposed to be about the year 1817,) to the end of 
1832, may be very briefly stated. I will invite the 
reader to be present with me at a meeting of medical 
gentlemen, representatives from every portion of the 
world where this plague had appeared, and whilst yet 
on its journey of destruction. The meeting shall be 
in London or Paris. The chair is duly taken, and the 
first speaker introduced. His words are few: "Gentle- 
" men, I recommend timely and copious bleeding; I know 
<c this treatment to have been proved by marked suc- 
" cess !" "The learned gentleman will excuse me, if I 
" differ from him, and think a much higher degree of 
" confidence due to mustard emetics, and therefore re- 
" commend them to your notice;" are the words of the 
second. " I," said a third, " have tried both these 
" modes, and have found them useless, and resorted to 
" the use of the hot air bath, which never disappoints 
"me." "Gentlemen," said a fourth, "you are all, I 
" trust, aware that I have taken no small pains to avail 



8 



" myself of all the light which science has thrown upon 
" our art, but I must say, with due deference to others, 
" that I have been forced to a very different conclusion. 
" I am in favor of introducing into the system a large 
" quantity of neutral salts ) which will liquefy and redden 
" the blood, and so restore the functions of circulation /" 
" If," replied the fifth, " the last speaker's patients, 
" as well as ours, were hogs and herrings, his extra- 
" ordinary method might answer ; but as the matter 
" stands otherwise, I do not think that salting our 
" patients will cure them. I therefore recommend the 
" mechanical dilution of the blood by the injection of 
" warm water, or salt water y into the veins V "All these 
" remedies," said a sixth, "are departures from ancient 
" and known usage. Give good brandy /" " Why not 
" try Gajeput oil ? it has been sold by the barrel, and 
" never fails," suggested a seventh. " I recommend," 
urged the eighth, the "free use of opium, as the safest 
" soother in the pangs of cholera !" " Human life and 
" health are too precious to be risked, gentlemen," sol- 
emnly declared the last speaker, "by these divers and 
" strange experiments ; but for my own part, I have 
" trusted, and shall still trust, as do the large body who 
" think with me, in calomel alone! Three cheers, and 
" the ' congress' breaks up, with the thanks of the 
" meeting to the Chair, and the eulogium of the Chair 
" on the vast body of solid science and useful experience 
" brought out at the meeting !" 

But whilst this meeting is but the fancy of the 



9 



writer, every medical man knows that I have here 
given all that had been said and done up to that 
day in the treatment of epidemic cholera. How 
highly these recommendations were esteemed by the 
leading men of the old school, will appear from 
the opinion of Dr. Thomas Watson, of London, 
who practised during the epidemics of 1831-2, 
and who is one of the most distinguished men in the 
profession. " Now," he says, " I would not willingly 
" mislead, or deceive you on this point, by speaking 
" with a confidence which I really have no warrant 
" for, of the success, or propriety of any of these expe- 
" dients. Never, certainly, was the artillery of niedi- 
" cine more vigorously plied — never her troops, reg- 
" ular and volunteer, more meritoriously active. To 
" many patients, no doubt, this busy interference made 
" all the difference between life and death ; but if the 
" balance could be fairly struck, and the exact truth 
" ascertained, I question whether we should find that 
" the aggregate mortality, in this country, was any 
" way disturbed by our craft." — See his Lectures on 
the Practice of Medicine, page 811. 

During the epidemics of 1848 and 1849, the experi- 
ence of the School did not devise an}?- better means, 
nor were its efforts crowned with any greater success ; 
as the sequel will show. 

In the face of this hopeless and complete inability 
to meet the present dreaded approach of Cholera, on 
its third periodical march of death, by any new med- 



10 



ical appliances that could offer a single chance of 
hope, the men of honor, ability and candor — and such 
only can afford to speak the truth — surrender grace- 
fully to the enemy, go out from the battered fort of 
Therapeutics — but with their flag of Science still 
flying, promising to renew the conflict once more on 
the wide and open field of Sanitation ! And on this 
field we wish them, with all our hearts, abundant 
success, and promise them large re-enforcements to 
strengthen their hands and aid them to certain vic- 
tory. 

To sustain this view of the present condition of 
the Old School of Medicine, I shall now quote from 
the best and most experienced living authority on 
this subject — a gentleman who has had many years' 
experience in India, and is now Deputy Inspector- 
General and Professor of Military Medicine, under 
the British Government — Dr. Maclean. In a lecture 
delivered at the Royal Victoria Hospital, Netley, at 
the beginning of the present year (1866), he uses the 
following language to men who were about to go out 
to India to fight with this foe on its native battle- 
ground : — 

" Dr. John Macpherson, late of the Bengal army, 
" and for many years one of the physicians to the Cal- 
" cutta General Hospital, one of the most conscientious 
" observers and recorders of facts in our profession, 
" after approvingly quoting the melancholy words of 
" Bauchardat (who concludes his account of what he 



11 

calls the ' funeste champ de bataille of the cholera 
epidemic of 1850' with the confession { that he 
had not only not seen a single efficacious remedy, 
not one discovery, not a single thought indicative 
of scientific progress'), adds : ' The experience of 
the last fourteen years in Bengal has not been dis- 
similar. How many of the new remedies have 
stood their ground ? Saline enemata, the successors 
of saline injections into the veins, have had their 
day. Croton oil and opium pills were at one time 
pronounced to be nearly infallible. Bloodletting I 
saw at one time employed ; it is now entirely 
abandoned. A Madras surgeon found carbonate of 
soda wonderfully efficacious, as if to neutralize the 
acid of the Austrian cure. Ether and chloroform 
were immediately seized on, not only to allay the 
spasms, but to cure the disease. One surgeon re- 
commended to the service the practice of parboil- 
ing his patients, but lived to abandon the procedure. 
The cold sheet, whether dipped in plain cold water, 
as in Bombay, or in an acid solution, as in Bengal, 
has been considered to work wonders. Quinine was 
recommended to the public, and immediately the 
newspapers were filled with the accounts of cures 
worked by the indigo planters by means of it. Ni- 
trate of silver has been recommended here, as in 
France, and may deserve a more extended trial. 
On the ground that, as an absence of bile from the 
evacuations was the great characteristic of cholera, 



12 

" ' its restoration must be the great remedy, ox-gall 
" c was recommended — and tried/ Among all these 
" remedies, adds Dr. Macpherson, 1 1 can scarcely say 
" * that any one is an important addition to our stock, 
" l except, perhaps, chloroform.' 

" This passage was often in my mind in the early 
" part of this winter, when men's minds were agitated 
" by the presence of the cholera in Southampton and 
" other places. You must all remember how not only 
" the professional journals, but the daily newspapers 
" also teemed with ' cures' and t remedies' for cholera. 
" One gentleman thought he had made a great dis- 
" covery in hot mustard baths, and announced it in 
" The Times with an honest confidence that somewhat 
" surprised others as well as myself. The truth is, 
" that seeing how prominent a symptom low temper- 
" ature is in this disease, attempts to stimulate the 
" surface and restore the circulation in this way were 
" amongst the earliest remedies that occurred to the 
" minds of physicians — first in India, and subsequently 
" in this country. I well remember that all the 
" places set apart in Edinburgh for the reception of 
" patients, on the occasion of the first epidemic, were 
"fitted with every conceivable means for applying 
" both dry and moist heat. The extract given above 
" from Dr. Macpherson shows that in India the ' par- 
" ' boiling' system has had its advocates; and hundreds 
" of living Indian practitioners can testify to the 
" futility, to say the least, of this method, even when 



13 

" mustard has been added to give more activity to 
" the measure. My colleague Dr. Davidson, Assistant 
" Professor of Pathology at Netley, assures me that 
" he has seen as many as twelve patients subjected to 
" this method of treatment in one night at Peshawur. 
" I wish I could say that only negative results have 
" been obtained ; but it is not so. In any but the 
" trifling sort of cases in which this remedy was used 
11 in Southampton, it is not only a useless, but a 
" highly dangerous remedy. To take a man in the 
" collapsed and pulseless stage of cholera out of the 
" horizontal posture, where alone there is a hope of 
" safety, and to plunge him in this condition into a 
" bath heated to the highest bearable temperature 
" short of absolute scalding, to which mustard in large 
" quantities has been added to make it more stimu- 
" la ting, is, in my judgment, about the surest method 
" that can be taken to exhaust the little remains of 
" vitality left. Experience has abundantly proved 
" this, for so many men have perished in this way 
" actually in the baths, that the practice thus urged 
" on the attention of the public as novel and effica- 
" cious has long since been abandoned in India. The 
" novelty to me was not the treatment, but the ex- 
" planation of the modus operandi of the remedy. 
tl How mustard and hot water, used in this or any 
" way, can l aerate the blood in the capillaries/ I do 
" not understand, and therefore cannot explain." 
Dr. Maclean then enters on a discussion of Dr. 



14 

Chapman's new theory of treatment by means of ice, 
which he does not consider sufficiently tested by 
experience to warrant any decided opinion in its 
favor ; and goes on to say : 

" Of all the methods of treating cholera that have 
" come under my notice, the most extraordinary is 
" certainly that which, for want of a better name, I 
" venture to call the ' corking-up method.' The essence 
" of this plan consists in restraining the evacuation of 
" the rice-water stools by mechanical means ; by ban- 
" daging, and, it is gravely added, ' by plugging the 
" ' anus !' The author of this ingenious invention is 
" of opinion that if he can only cork our patients up, 
u as he would a bottle, all must be well. It does not 
" appear to have occurred to him that once the serum 
" of the blood has escaped into the bowels, it may as 
" well be in the chamber-vessel as in the intestine, 
" for all the use it is, or can be, to the patient. So 
" completely does this fallacy of regarding the mere 
" purging as the essence of the disease underlie this, 
" as it does so many other remedies and modes of 
" treatment, that the author of this hopeful method 
' c holds out, as one of the advantages of mechanically 
" restraining the evacuations, ' that in time they will 
" ' be re-absorbed!' — i.e., that this poisonous excretion 
" will be again taken into the system to the advantage 
" of the sufferer ! Why not treat our patients suffer- 
" ing under typhoid fever in like manner? The diar- 
" rhoea in that disease is very ' exhausting.' Why 



15 f 

" don't we learn from this gentleman, cork our patients 
" up, and so obtain from them all the advantages of 
" this i re-absorption V No wonder the public were 
" stunned and bewildered by the cholera literature of 
u the past three months ; no wonder a cry of ' no con- 
" ' fidence' arose on every side when ' doctors' thus 
" c differed,' adding to the panic and distrust by pro- 
" mulgating crude, contradictory, and often irrational 
" modes of treatment. 

" Calomel has been used to fulfill every indication 
" in turn, according to the peculiar belief of the 
" prescriber. Some give it as a purgative, others as 
"a sedative; not a few 'to stimulate the secretions.' 
" 1 have seen it given as a cure for vomiting. Then 
" we have a pretty numerous class who give it for no 
" reason in particular. Calomel is the trump-card in 
"their hands; so, like good whist-players, 'when in 
" ' doubt,' as men are apt to be in dealing with cholera, 
" they 'play trumps' — they give calomel. I have seen 
" it given in every conceivable way, and for every 
" possible and impossible end — in grain doses every 
" hour or half-hour, and by heroic practitioners in 
" scruple doses again and again. But, gentlemen, it 
" is the old story. Calomel is of no use during the 
" stage of collapse ; but by-and-by, when the powers 
" of life begin to revive again after the shock is over, 
" the first thing the system has to deal with and to 
" dispose of is twenty or thirty grains of calomel. 
" What results 1 Very often vomiting of that ' green 



16 

1 paint-looking matter' of which I spoke appears, 
and you know how hard it is to stop that ; or bilious 
dmrrhcea is excited, which soon brings the case to 
an end. At the best it disturbs the stomach and 
interferes with nutrition. At such a time Nature 
needs the helping hand of the physician to sustain 
and assist her in the life and death struggle, instead 
of being searched and goaded by powerful drugs, 
prescribed no matter with what intention. Called 
to see a case of cholera, a few months ago, I found 
calomel in combination with opium being ' poured in' 
every hour. I ventured respectfully to ask the 
reason why; the patient being in a state of collapse, 
the medicine was accumulating in the stomach like 
water behind a barrier, ' What,' I asked, l do you 
1 expect will be the action of all this calomel 
1 when the barrier gives way, when the functions 
1 begin to be restored?' The prescriber was not very 
sure, thought perhaps it might have a l cholagogue 
1 action — stimulate the bile.' I might have asked, 
Is it not conceivable that Nature will do this her- 
self? And why not stimulate the kidneys as well? 
Why concentrate all your attention on the bile? 
Is the biliary more in abeyance than any other 
secretion? and so on. I do not think these are 
impertinent questions. I recommend you to put 
them to yourselves when you are tempted, in mo- 
ments of doubt, to prescribe as D'Alembert said we 
sometimes do — using physic as a strong but blind 



17 

" man uses a club in a crowd, hitting friend and foe 
" with equal impartiality. 

" Stimulants, both of a medicinal and alcoholic 
" kind, have been much resorted to in cholera, and 
" very naturally. The prostration of the powers of 
" both circulatory and nervous systems is so extreme, 
" that we cannot wonder that strenuous efforts have 
" been made to rouse and to sustain them by the free 
" use of remedies of this class. Yet I think that those 
" who have used them most, if observant and candid 
" men, must admit that they have not answered their 
" expectations"; and, at least, all must allow they re- 
" quire to be given with a cautious hand. They are 
" useful, as I shall presently show, when given at the 
" proper time and in the right way. I do not think 
" they are of any use during the stage of collapse, 
" when, at first sight, they might appear most appro- 
" priate. 

" We have thus examined the therapeutic value of 
" the remedies that have been most used in cholera. 
" The result is not encouraging. I may say I have 
" tried most of them, and the above is the result of 
" my experience. You will perhaps say — Do you 
" then advise no treatment in cholera at all 7 Well, I 
" can only say that, in the collapsed stage, I know no 
" drug worthy of the smallest confidence. Must we, 
" then, abandon our patients to Nature, and do no- 
" thing? Must we suffer them to die without any 
" effort to save them? My answer is, that efforts of 



18 



" the kind described above are futile; your remedies 
" are either vomited, or, if retained, are inert, and if 
" given, as they often are, in excessive quantities, 
" they become a serious source of embarrassment, 
" interfering above all with nutrition. If opium, the 
" preparations of lead, or calomel, have been abstained 
" from, Nature, in the stage of reaction, starts, so to 
" speak, fair, which I am sure is not the case when 
" weighted with one or other, or, as, I have often 
" seen, with all the above. Because I objected to 
" bleeding intemperate old soldiers of twenty years' 
" service in tropical and malarial climates, taking 
" blood away to the extent of upwards of a hundred 
" ounces when suffering from peri-hepatitis, I was 
" called the other day ' the Micawber of medicine,' the 
" gentleman ' who waits to see what will turn up.' 
" Well, I don't object to the name in the least; I had 
" rather be the ' Micawber' than the ' Sangrado' of 
" modern medicine. The more I have l waited' upon 
" Nature, the less I have attempted to force her — the 
" more I have found that ' something' is pretty sure 
" to l turn up' to the advantage of my patients. Very 
" notably has this been the case in cholera. Some — 
" unfortunately a great many — patients in severe 
" epidemics, will die, but such cannot be saved by 
" pouring drugs into them in the collapse of this 
" terrible disease. 

" No remedy has been more used — I should rather 
" say abused — than opium. Most India practitioners 



19 

" have abandoned it as treacherous and dangerous. I 
" must earnestly caution you against its use. In the 
" stage of collapse, if it is retained, it is, it must be, 
" useless. But when reaction sets in, the opium, pre- 
" viously inert, begins to act, and is at once a serious 
" hindrance to the restoration of the secretions, and if 
" the quantity given has been large, often hastening 
" on cerebral symptoms ending in coma. These are 
u its dangers, without, so far as I know or could ever 
" discover, a single compensating advantage. 

" What of astringents ? No class of remedies have 
" been more used in cholera. The great anxiety has 
" ever been to l restrain the evacuations.' Yet I am 
" persuaded that the mere purging rarely kills ; and, 
"as I have already said, in the most fatal form of 
" cholera there is no purging, or very little. Graves 
" recommended acetate of lead with opium, and this 
" combination has been more used than perhaps any 
" other remedy, in cholera. Sometimes capsicum is 
" added by way of a stimulant. Here, again, we are 
" met by the old difficulty : what service can we ex- 
" pect from such combinations during the condition of 
" collapse ? Very little, I fear. And what is likely 
" to be the action of large quantities of this powerful 
" sedative during the stage of reaction ? Will it aid, 
"or embarrass the struggling system? Again, sup- 
" posing the remedy to be retained, and to act, how 
" far do we benefit the patient by controlling the 
" purging ? I. don't believe that cholera is caused by 



20 

" l hyperemia of the nervous centres from heat.' If 

" this hyperemia be present, there is something else 

" present also, some materies morbi, some subtle poison 

" — what, I know not, I do not pretend to know. If 

" it be the case, as so many suppose and as I believe, 

" that this poison is in part at least eliminated in the 

" intestinal canal, how far do we benefit our patient 

11 by restraining it? I have ridiculed the attempt to 

" secure this object by mechanical means : will the use 

" of astringent drugs stand the test of argument any 

" better 1 But then experience has sanctioned them. 

" Alas ! I have had much experience, and I am sure 

" that I was more successful, as a rule, when I with- 

" held them. Still, there are cases where some as- 

" tringent is necessary. Granting that the purging, 

" within certain limits, is salutary, it may go on to 

" such an extent as to lower the patient hopelessly. 

" In such cases an effort must be made to restrain it. 

" Acetate of lead should then be used, in solution, but 

" without opium. In such cases pernitrate of iron, in 

" full doses, might be tried. My friend Surgeon-Major 

" Mudge, of the Madras Army, made a trial of turpen- 

" tine in egg emulsion with an aromatic, and in a 

" number of cases found it more than answer his 

" expectations. The sufferers in whom Dr. Mudge 

" tried it were all Asiatics. It does not seem to have 

" caused vomiting, or even nausea — the objection to 

" which we might expect to find it open, as turpentine 

" is generally a nauseous medicine. In one epidemic 



21 

" I found nitrate of silver exceedingly useful as an 
" astringent in excessive purging, particularly, as I 
"noted at the time, in children; some of my native 
" pupils used it extensively during the same epidemic 
" in the great native city of Hyderabad, and with so 
" much success as to gain for themselves considerable 
" reputation. I used it again, in the. following year, 
" with disappointing results — another proof of the 
" i varying constitution of epidemics. 7 

" I have felt it to be my duty to speak distrustfully 
" of many methods of treating cholera which have 
" lately been urged on the attention of the profession 
" and the public. Many of them, if you will excuse a 
" homely metaphor, are the cast-off clothes of Indian 
" practitioners, brushed up to look like new. ' Old 
" ' Indian' doctors know them well, and make a pres- 
" ent of them to their new and complacent wearers 
" without a sigh. Well, gentlemen, I know no l cure' 
" for cholera. What is more, I suspect we are never 
" likely to see one. Nevertheless, I believe we shall 
" in time extinguish cholera as we have, in this coun- 
" try at least, extinguished plague. This is one of the 
" certain triumphs that await the slow progress of 
" sanitation. It is probable that a whole generation 
" of obstructives must pass away before even the 
a initiatory steps in this great movement are likely 
" to be taken. We have sanitary commissions in all 
" the great Presidency towns of India ; but they are 
" without the necessary authority to act in an effect- 



22 



ive way, and, in some instances, very notably in 
Madras, the whole weight of those in power is exer- 
cised to obstruct the efforts of the commissioners 
for the public weal. We are not very much better 
off at home. Men ignorant or indifferent • in such 
matters abound in high places, and in almost every 
municipal body in the kingdom trading selfishness 
and apathy prevail to detriment of the public health. 

" It would be unprofitable to pursue this part of my 
subject further. I wish I could hope that we had 
seen the last of a practice which is neither dignified 
nor useful. 

" Note. — Since the above lecture was delivered, I 
have seen and read with pleasure and profit Dr. 
George Johnson's Notes on Cholera. This able phy- 
sician has been led to much the same conclusions as 
to the action of most drugs in cholera as are ex- 
pressed above. Dr. Johnson puts more faith in the 
action of purgatives than I can do ; for, like every 
known class of drugs, they have been freely used 
in India. I sincerely trust that Dr. Johnson may 
never see so many cases of cholera as I have done ; 
but I cannot help thinking, should it be otherwise, 
that he will see cause to believe with me that, in a 
vast majority of cases, there is quite enough purging 
without artificial aid. Still, for my own part, if 
again smitten by cholera, let me rather fall into the 
hands of a purging than an astringing physician — 
one who thinks he does you service by retaining 



23 

" what Nature is so solicitous to expel from the sys- 
" tem." # — See London Lancet, for May, 1866. 

But as modes of treatment, like other agencies, can 
be fairly judged only by their results, I will now give 
the official statistics of the School under consideration, 
reported by its own authorized agents. In 1831-1832 
there were, in New York City alone, 5232 cases of 
cholera, and of these there died 2031, or nearly two 
out of five of the whole ! But of the above number, 
there were treated in the hospital, 2373 ; and in pri- 
vate practice, or at their homes, 2859 patients. Of 
the former, 1094, or about one-half died ; of the latter, 
937, or nearly one-third died. In France and Italy 
the results are no better. We have returns from 
twenty-one hospitals, and the average gives 63 deaths 
in every 100 cases. In the epidemic of 1848-1849, 
we take from the government reports of Great Britain, 
of 24th of February, 1849, these figures — there were 
reported 12,485 cases, of which 5546 died, 3788 re- 
covered, and still under treatment 3164 — that is, more 
than one-third had died, and more than two-thirds 
had not recovered. 

In the city of New York, in the same year, there 
were, during fifty-two days' private practice, 2631 
cases and 915 deaths, or about 35 out of 100. In five 
hospitals, there were 1901 cases, 1021 deaths, and 880 

* The justly celebrated Magendie, in his address before the College of 
France, in February, 1846, says: "If I were to say all I thought, I should 
" add, that it is especially in those cases in which the most active means are 
"employed that the mortality is the greatest." 



24 

cures ; by which it appears that more than one-half 
died. During three months, in Liverpool, the most 
favorable average gives 46 deaths in every 100 cases ! 

These facts and figures require no comments ; they 
are such results as might naturally flow from that 
very " rational" and " scientific" mode of treatment 
quoted above. 

I have now laid before my readers the opinions and 
statistics of the Old School in the treatment of cholera. 
These are drawn from undoubted and unimpeachable 
sources. They are the expressions of independent 
thought and unbiased observation. They are all that 
the Old School has been able to do for humanity, and 
for the world, in Therapeutics, at least, since " the 
a blind, the maimed and the halt" sat, in hopeless 
expectancy, " waiting for the moving of the water," 
till this present year of grace ! And yet, strange to 
say, we are told by thousands of these gentlemen 
every day, that they are the exponents of " scientific 
" medicine," of "rational treatment," and " effectively- 
" curative means !" But let it be borne in mind that, 
as the swaggering subaltern ranks but indifferently 
by him who can " set a squadron in the field," the 
" village statesman" is heeded little when Chatham, 
Burke, or Webster speaks, so " medical gentlemen," 
" whose fame full four miles round the country ran," 
had better be prudent when such men as Watson, 
Liston, Maclean, and Magendie have spoken to the 
world ! 



25 



Is it, then, an unnatural result, or a wonderful phe- 
nomenon, that, wearied, oppressed and fettered by 
this conglomerate of contradiction and empiricism, 
which has hardly moved an inch or changed an atom 
since the days of Hippocrates, there should have been 
found in its ranks some who desired more light, more 
safe, scientific, and effective methods of healing? The 
presence of a New School of Medicine is a standing 
demonstration that such men existed in its bosom. To 
this School, its claims, its position, its character and 
its results, I shall now direct attention. The Homoe- 
opathic School is to-day known, honored, trusted, 
and legally protected in all its rights and privileges 
in every well-governed nation and country on the 
globe ; and may fairly and without presumption claim 
a hearing on this coast, when it speaks for the lives 
of the people — for a more simple and effective mode 
of saving them ! 



26 



CHAPTER II. 

HOMCEOPATHY AND ITS RESULTS. 

As much popular ignorance prevails on this Coast 
as to the nature of Homoeopathy, and the qualifica- 
tions and standing of its practitioners, and no effort 
having been made to place these matters fairly before 
the public, I may be allowed to state that, over sixty- 
four years ago, a reformation in Therapeutics, or the 
mode of administering medicines, and the principles 
on which they should be administered, was inaugu- 
rated by Dr. Samuel Hahnemann, an accomplished 
scholar, a clear and careful observer and a profound 
medical philosopher. He published to the world his 
discovery as soon as made. It consisted in this pro- 
position : There exists a general law which guides in 
the selection of remedies for all forms of disease ! 
This law is expressed by the formula, Similia simili- 
bus curantur; or, in English, that any substance which 
produces in the healthy an affection similar to any 
given disease, will cure the disease which resembles 
this affection. Every physician practising according to 
this law is a Homoeopath. But, by a deduction from 
this mode of administration, founded upon experience, 



27 

it became necessary to give the medicines in much 
smaller doses than they had been given in the other 
school. This arose from the fact that when the 
medicines were first given in the usual quantity, a 
serious aggravation of the disease took place. In this 
reduction, however, every physician is left to the 
guidance of his own judgment and experience as to 
the exact size of the dose. 

Only one medicine is given at a time. 

The medicines are always " proved," or tested on 
the healthy before they are given to the sick. 

These indicate the principles on which Homoeopathy 
stands, and the practice of the School. The associates 
and immediate followers of Hahnemann were converts 
from the Old School, men of education and experi- 
ence, who were fully qualified to test the truth and 
practical value of his discovery. And it will be 
observed that it admits of a very easy and simple 
test. 

It will be necessary for me to notice here that in 
all the other branches of medical science there exists 
no difference of opinion between these schools; — 
Anatomy, Physiology, Surgery, Obstetrics and Che- 
mistry are common ground, on which we meet as 
equals, and on which the discoveries have been both 
rich and extensive — much to the honor of the Old 
School — so that the law of administration, the quality 
and quantity of the medicines given to the sick mark 
" the line on which we are fighting it out." 



28 



As to the standing of each physician who calls 
himself a Homoeopath, he must be what every Allo- 
path is expected to be, — but what every Allopath 
certainly is not, — an educated gentleman, — -a legally 
qualified graduate of a medical college, properly so 
called, — one who has well and carefully studied 
every branch of medical science, and who devotes all 
his time to the practice and study of his profession ; 
before he can claim any recognition in the Homoeo- 
pathic School. The man who professes his readiness 
" to practice according to either system," proves that 
he knows neither. The man who takes up a "Manual 
" of Domestic Practice" and a small case of globules, 
has as little claim or relation to the New School as 
the man who takes up the little "dose-book," in which 
all is ready cut and dry, and fit for his pocket, has to 
the Old. These are only " gentlemen on their last 
legs," who have turned out to play the doctor : that 
being a calling which, in this country, any one is at 
liberty to take up without legal restriction, or proba- 
bility of detection. 

Consultations are incompatible, because ineffective, 
between the members of each School, except in 
surgical cases. As surgeons, there must always exist 
perfect harmony between qualified and skilful men and 
decided advantage to the patients be the practical 
result. 

It would be unnecessary to say a word as to the 
present position of Homoeopathy, were it not that our 



29 

city and State have hardly kept pace with the pro- 
gress of the world in anything, save the production 
of material wealth, for the last seventeen years. But 
science and literature have been progressing elsewhere 
without our knowleege or our aid. Homoeopathy has 
not slept. Its literature, its colleges, its hospitals, its 
dispensaries, its practitioners and their vast body of 
supporters are as clearly and distinctly a marked 
feature of the age as the motive triumphs of steam. 
It made its appearance in the United States in 1827 ; 
and in 1828 had just two medical men to represent it. 
To-day, it reckons nearly five thousand practitioners ! 
How these are patronized, and by what class of the 
community, let the world judge. There is not a town 
or a city in which every qualified member of the 
School has not as much to do as he can accomplish ; 
and even some, who are no honor to it, or part of it, 
succeed under the shadow of its name ! And all this 
success is obtained among the best educated and most 
intelligent of the people. Indeed, it finds favor only 
with these everywhere; since it appeals only to such 
as are able to rise above the habits of past ages and 
and the material aspects of heroic practice. Its col- 
leges are legally established, on the same footing as 
all others, in New York, Philadelphia, Chicago, St. 
Louis and Cleveland. Its hospitals and dispensaries 
— its monthly and quarterly journals, are public 
institutions and creditable witnesses in almost every 
city in the Union, deserving the name. In South 



30 



America its triumphs are as marked and its success 
as great. By a recent order of the authorities of New 
York, hospitals have been ordered for Homoeopathic 
practice, in view of the approach of cholera. 

In 1830 it was introduced into England, by Dr. 
Romano, who was called from Naples by the Earl of 
Shrewsbury, its first advocate : whilst the Queen 
Dowager, two years afterwards, was restored to health 
under the treatment of Dr. Stapf, who was brought 
from Germany for special attendance. To-day it fills 
the land ; its advocates are the royal, the noble, the 
educated — those who can look back to ten generations 
of culture, taste and refinement. When I say that the 
" Fairs," or " Bazaars," for the benefit of its hospitals, 
have been held in rooms exclusively used by the 
Queen's Life-guards and adjoining her Royal Palace, 
that at the tables may be seen, as saleswomen, her 
immediate blood-relations ; and some of the wares 
offered by their hands the handiwork of her royal 
daughters and late royal mother ; I have said enough 
to establish my point. Shall I remind my readers of 
the fact, lately so public, that some of the Life Assur- 
ance Companies of London have declared in favor of 
taking risks on the lives of those under Homoeopathic 
treatment at a much reduced rate of premium (whilst 
some of our own, never slow to profit by good exam- 
ple,) have acted on the same principle. Those who 
desire further information on these points may con- 
sult our public English organs, The British Journal 



31 

of Homoeopathy — now in its twenty-fifth year — and 
the Monthly Homoeopathic Review, and judge whether 
they compare favorably with any medical periodical 
which the world has produced. 

The Emperor of Austria early placed Homoeopathy 
on an equal footing with Allopathy — allowing them a 
fair trial to measure lances ; and with what result 1 
Homoeopathy has spread throughout the length and 
breadth of the empire with marked and distinguished 
success, and is more generally practised in Austria 
than in any other part of Europe. The Medical 
Schools are divided between both practices, and each 
student left to his free choice. 

In 1844, Homoeopathy was established in Hungary 
by a decree of both Houses, under the Viceroy Joseph, 
and still holds its own and progresses as elsewhere. 
In Prussia a Royal College and Hospital are estab- 
lished. Both the King and the Prince of Prussia 
have, as their medical advisers in-ordinary, Homoeo- 
pathic physicians. 

Throughout all Germany, the birthplace of Hahne- 
mann — and whence, by the persecution of the apothe- 
caries, he was once exiled — he is now almost canon- 
ized ; statues are erected to his memory, and the 
reign of the New School perfectly triumphant. 
Schools, colleges and hospitals abound everywhere. 
In France, equal rights and privileges are granted to 
the School, and brilliant marks of success have 
crowned it, both in private practice and in the wards 



32 

of the hospitals set apart for its trials. In Russia, the 
late Emperor's ordinary medical adviser was a Hom- 
oeopath ; under whom he died. Though this may 
prove no recommendation of the system, it proved the 
Emperor's faith ; and, as Emperors as well as plain 
people have often died under the other system, I do 
not see the point to be very strong. It is, however, 
still the court practice in that royal household, and 
established in the empire by legal authority, and its 
share of military and civil practice guaranteed. 

Among the students of the Founder of Homoeo- 
pathy, in Paris, about the year 1836-1838, was a 
young Spanish physician, who spent a large fortune 
in translating the works of his new master into his 
native language, for the benefit of his nation. His 
only reward, on his return to Spain, was derision and 
neglect. His early death was caused by undeserved 
and painful disappointment. In 1848, however, we 
find Dr. Nunes, the President of the Homoeopathic 
Society, receiving the " Grand Cross of the Royal 
Order of Charles III," from the hands of Isabella II, 
and the appointment of physician in-ordinary to her 
majesty. In 1864 we find him rewarded with the 
rank of marquis, by her most catholic majesty. And, 
by a royal decree of the 5th of January, 1865, we find 
a Homoeopathic Hospital and Chairs of Instruction in 
its therapeutics, established in Madrid, the cost to be 
defrayed by the Government: In Italy it moves as 
fast as it is possible for new ideas to progress in so 



33 



conservative a nation ; — " still it moves," — and is very 
well represented. The society has received, by legal 
enactment, the title of " Royal Academy." This is 
equally true of the Two Sicilies. And the Duchess of 
Parma has established a Homoeopathic Hospital in her 
Royal Palace. 

So much, then, for the spread and present aspect of 
Homoeopathy. I come to my next question : What 
has it done, and what can it do, in cholera 1 

In 1831-32, in Vienna, there were 581 cases of 
cholera treated Homceopathically, of which 49 died, 
or eight per cent. The well-known Dr. Quin, late 
Physician in-ordinary to the King of the Belgians, and 
afterwards to the late Queen Dowager and the Duchess 
of Kent, gives a report of the treatment of ten Hom- 
oeopathic physicians on the Continent, giving, as the 
worst result under any one of them, one death in every 
five cases. Of these, Dr. Weith, of Vienna, treated 
125 cases, and lost only 3 ; or cured 40 out of every 
41. They had 1093 cholera cases, they lost 95 and 
saved 998 ; that is, 21 out of 23 recovered ! In April 
1832, by order of the King of Bavaria, Dr. Rath made 
an official report on the treatment of fourteen Hom- 
oeopathic physicians. They had treated 1269 cases, 
saved 1184, lost 85. In Russia and Austria, at Berlin 
and Paris, 3,017 cases are reported, of which 264 died 
and 2,753 recovered ; giving an average of more than 
ten out of eleven saved ! By order of the Emperor 
of Russia, the Consul-General, Eustaphieve, reported 



34 



as having taken place in 1830-1831, 1,270 cases in 
different parts of Russia under Homoeopathic treat- 
ment. Of these, 1,162 cases were saved, and 108 
lost — or, nearly one death in every twelve cases. 

In 1848-1849, there is a return of 162 cases having 
taken place in Liverpool. The cures were 119 ; deaths, 
43. In New York, under the care of 22 physicians, 
from the 1st of July to the 9th of October, there 
were 350 cases, of which 53 died, or a little over 15 
per cent. In Cincinnati there were 1,116 cases, and 
only 35 deaths, or a mortality of 3.1-7 per cent. The 
gross result obtained in Edinburgh, Liverpool, New 
York, and Cincinnati, was 4830 cases, of which 445 
died, showing 91 out of every 100 saved ! 

In 1853, for the months of May, June and July, we 
have a report from Shahabad, India, of 629 cases ; 
deaths, 199, cured, 430. 

From a comparison of the statistics of both Schools 
now before us, it would appear that under Allopathic 
treatment, in general practice, four times as many 
cases of cholera are lost as under Homoeopathy ; and 
three times as many in private practice. These facts 
speak for themselves. They are the expression of 
mathematical demonstration, and have never been 
called in question ; and were I not restricted from en- 
croaching on space, which I require for matter of more 
importance, I could show, from the statements of the 
Government officials — members of the Old School — ap- 
pointed to ascertain most of the facts above quoted, 



35 

the most candid and unreserved acknowledgments in 
favor of the New School over the Old, in dealing with 
Epidemic Cholera. 

But the majority of the inhabitants of this Coast, 
especially the earlier settlers, may very naturally feel 
some surprise at the preceding statements. To them 
they will, perhaps, seem new, startling, and even in- 
credible. They may, therefore, be pardoned if the 
question should naturally arise : " If Homeopathy is 
this simple and effective mode of cure which you have 
described, then why, we desire to know, have not all the 
doctors everywhere adopted it ? Are they not ready 
to avail themselves of every new improvement and 
addition to their system V 1 Both points are well and 
fairly made. I meet the second point first ; and ad- 
mit that they are always ready to try every new rem- 
edy, but only as an addition to, or a patch on, " Old 
Physic." But Homoeopathy is a total reformation — a 
radical change, an abnegation of old therapeutics, 
both in principle and practice — an unlearning of all 
that has been acquired in the choice and administra- 
tion of drugs ! In reply to the question, " Why is it 
yet in the minority, and not embraced by the doctors 
generally V I answer : First — that in all ages and 
countries, the practice of medicine has been consid- 
ered a sort of second Religion ; and that next to the 
creed to which people look to save their souls, the creed 
which professes to save their bodies has the firmest 
hold on their prejudices. Until within a comparative- 



36 

ly short period, the two offices were blended in the 
same venerable personage ; the "medicine man" and the 
priest were one. Second — Great truths have always 
developed and traveled slowly. The first sixty years 
of the Christian Reformation gave little promise of 
later poogress, and the journey to the end is still long 
and toilsome. It is not yet one hundred years since 
the effulgence of the Gospel extinguished the flames 
that had consumed our unfortunate "witches." 

It was long before it would be granted that 
steam could relieve men and horses from the 
heaviest portion of their toil, cause the mill to 
grind without its motive stream, and fleets to 
traverse the ocean indifferent to the uncertain 
winds ! These, the impossible dreams of yesterday, 
are the facts of to-day. Third : But few men are 
gifted with the capacity for receiving new ideas, and 
still fewer to act on them, when they would over- 
throw established usages and cherished systems. 
Fourth : There are but few medical men who, having 
acquired by years of toil and drudgery a knowledge 
of prescribing medicines according to their Pharma- 
copoeia, are willing, or indeed able, to undertake, in 
advanced life and, perhaps, full practice, another long 
and tedious course of study, and of a new mode of treat- 
ment, which requires careful analysis, close and con- 
stant thinking and unwearied observation, before they 
can hope to feel at ease by the bed-side, and conscious 
that they are able to cope with acute and dangerous 



37 

maladies with fair prospects of success. Fifth : The 
amount of pecuniary risk involved — and at first it 
must be serious — has much weight with by far the 
largest number of men of every profession and call- 
ing. Sixth : The greatest and most difficult trial which 
falls to the lot of even the truly brave, though con- 
scious of right and of being engaged in the best of 
causes, is to stand out single-handed against the opin- 
ions of the multitude : — to bear the jeers, the scoffs, 
and scornful epithets of even the ignorant, the unre- 
flecting and worthless ! To be of the " unfashion- 
able minority, " even among the very " smallest 
people, " and in the " smallest community " re- 
quires more pluck and philosophy than falls to the 
share of the general run of men. But how impossible 
this hard labor, self-assured calmness and dignity for 
that large class of medical men, to be found every- 
where, who require to devote so much time, thought, 
and peculiar talent to the cultivation of those meretri- 
cious shifts that produce and maintain among the 
masses the impression that they possess professional 
gifts and attainments which Nature has denied them. 
Seventh. All know that " habit is a second nature ;" 
and when men have been for ages accustomed to be- 
lieve that in sickness they must swallow large quanti- 
ties of disgusting compounds, be reduced by the pain- 
ful ordeal of bleeding, purging and blistering, almost 
to the verge of dissolution before they can be restor- 
ed, it is not easy to convince either the patient or at- 



38 



tendant that both could do better by the aid of good 
nursing, plenty of cool air and water, and, in most ca- 
ses, a comparatively imperceptible atom of medicine. 

But the sophism, deduced from these heroic meas- 
ures, is ready in every one's mouth, when this harm- 
less method is suggested — " How can it do me good, if 
it does me no harm /" — a sophism easily refuted, since 
the whole economy of nature is its contradiction, but 
hard to erase from the undisciplined mind. 

These are but a few of the many answers that may 
easily be given to above questions. But they are suffi- 
cient to show that Homoeopathy is " doing as well as 
can be expected." And in being thus slow in its pro- 
gress it only fulfils its destiny and proves its celestial 
origin, as a spark of that Heavenly fire which at first 
only reached the earth in spite of the vigilance of the 
gods! 



39 



CHAPTER III. 



PUBLIC SANITARY MEASURES. 



The general question of public sanitary measures 
against the inroads of Cholera, in large towns and cit- 
ies, has been as well considered and as carefully inves- 
tigated as any that has ever occupied the public mind; 
and no question has been so ably and pressingly urged 
upon the attention of those at the head of public af- 
fairs at home and abroad. It would, therefore, be only 
a repetition of what has already been said to go over 
the ground again. It will be observed, however, that, 
whilst declaring himself well satisfied with the regu- 
lations adopted by the heads of public departments, in 
the cities and towns of Great Britain and India, Dr. 
Maclean expresses great regret at the open negligence 
and corruption of the subordinate officials whose duty 
it has been to give practical effect to those measures ; 
nor does he hesitate to charge them with incapacity 
and dishonesty, — with obstructing, rather than for- 
warding, the course of wholesome and safe legislation. 
The danger, therefore, arises not so much from want 
of knowledge as from delinquency. 

But as we live in a younger and more vigorous com- 
munity, in which, it may be thought, mal-administra- 






40 

tion has not had time to mature, it may not be unrea- 
sonable to hope that our sanitary measures may have 
more effective force, and be carried out for the benefit 
of the public ; and not retarded or obstructed for the 
accommodation of the few. It is a matter of course 
that no improvement can be made on a large scale in 
this, or any city without some disturbance of " vested 
interests," or " private rights ;" but as it is often found 
that these embrace the worst nurseries of moral deg- 
radation and disease, it would be uncharitable to sup- 
pose that they should be allowed to interfere for a mo- 
ment with the public good. 

We are aware that those interested in maintaining 
such places undisturbed, are always willing to make it 
a matter of some consideration to be left unmolested. 
But in view of the probable approach of Cholera, no 
one could suppose that, on this account, our officials 
would for a moment neglect the onerous and sacred 
trust committed to them. For should this destructive 
scourge reach our city in its present unprepared con- 
dition, among the large portion of the inhabitants it 
might sweep away, may be counted the families and 
persons of the officials themselves. It would, howev- 
er, be pleasant, as well as hopeful, for those who un- 
derstand these matters to see more attention paid to 
extensive and effective sewerage, more watchful care 
over the condition of our streets, — the speedy 
removal of all public and private nuisances from the 
city and suburbs, and a close supervision of the public 



41 

markets ; in which objectionable animal and vegetable 
matter will sometimes accumulate. 

It has been observed that in large cities, the haunts 
of drunkenness and degrading vices were the first spots 
selected by Cholera; and formed the centres from which 
it radiated and extended far out among the dwellings 
of the well-ordered and wealthy inhabitants. It 
would, therefore, be well if in our city it could, for the 
time being, be so ordered that there should not be 
found a drinking house, and a house of a worse class 
still, to alternate each other through whole streets ! If 
three of the corners of nearly all our street intersec- 
tions were not occupied by three drinking houses, 
(styled, for the sake of morality, " family groceries,") 
the fourth being invariably a drug store. This pecu- 
liar feature gave rise to a remark we heard a short 
time since, " that our street-crossings were guarded by 
three hells and a purgatory" 

It is true that by the suppression of so many of these 
places, there may be some considerable loss to the re- 
venue ; but the counterbalancing gain in the diminu- 
tion of crime, closing the fountains of demoralization 
and removing the head-quarters of disease should out- 
weigh this consideration. It does not seem to be good 
policy for a city or State to enrich itself at the expense 
of the degradation and death of the citizens. But, as 
these are public affairs, out of the reach of any private 
person, I shall now pass on to what is more within my 
province c^-to direct each family and individual as to 



42 



what they can do for themselves by way of prevention, 
and in cases of emergency. 



CHAPTER IV. 



PREVENTION. 



The mission of the true physician is to prevent ♦dis- 
ease where he can, to cure, if possible, and to palliate 
and modify, when neither prevention nor cure is 
practicable. He should appreciate its germs in early 
infancy, track its course through the periods of youth- 
ful development, and take due notice of its advances in 
the after stages and changes of life. He should give 
timely warning of the individual habits and general 
causes which invite and nurture it in each single pa- 
tient, as well as in the whole community. 

Whilst this is desirable in every form of disease, it 
is specially important in Cholera. Everything depends 
upon effective methods of prevention, and on arresting 
it during the invading stage. In order to accomplish 
the former, it is absolutely necessary to have some 
clear ideas of predisposing causes. Perhaps the very 



43 

worst of these, because the most difficult to control, is 
Fear, or Panic. Now, it should be borne in mind, and 
laid down as a settled principle by every intelligent 
person, at least, that Cholera is not contagious ; that 
is, that a person does not necessarily " take it," because 
he is brought into immediate contact with one who 
has Cholera. 

This question has been settled by the most experi- 
enced, careful and extensive observation of the most 
reliable and competent men of this age. Cholera is 
an Epidemic, not a contagion. It will be well for 
those who are subject to this weakness to remember 
the well-known fact that medical men enjoy an immu- 
nity from what are generally deemed infections. No 
reason can be given for this than that they are never 
afraid. The feeling of fear is as foreign to a true phy- 
sian in the discharge of his duty, as to a true soldier 
in the heat of conflict. And it is very important that 
neither medical men nor others should become alarm- 
ists by expressing themselves doubtful, or at all unde- 
cided on* so important a point.* Every one 
should remember the dialogue between the Turk 
and the Pestilence. " Where are you coming 
from ? asked the Turk. " From Smyrna, where 
I slew 2000 people," said the Pestilence. " I know 
that is not true," said the man, "for you killed 6000 

*The writer is aware of the long array of arguments for, and against contagion. 
The balance seems to him in favor of the non-contagionists. His unqualified af- 
firmative, however, has been given rather in the interest of humanity than on the 
side of mere theory. 



44 

there !" " You are mistaken," said the Pestilence : "I 
killed only 2000, but Fear killed the other 4000 !" 

Due regard to cleanliness in and about the dwelling 
and its apartments, must be kept steadily in view, 
and strictly enforced. No filth must be allowed to ac- 
cumulate ; water-closets, drains, sewers, etc., must be 
carefully looked after and kept in good condition. 
The free use of disinfectants is indispensable in every 
case. The most useful and easily provided are Quick- 
lime, Chloride of Lime, Coal-tar, Seat — in the shape 
of boiling water, or steam, required for purification of 
clothes, etc. — and Charcoal. Every intelligent per- 
son is acquainted with the use and value of the above 
substances as disinfectants ; but people are very apt 
to overlook their practical application. We are ready 
to do anything when we see the enemy, but often for- 
get him whilst at a distance. 

Personal cleanliness must not be overlooked. In 
general, little more than the usual ablutions, and the 
frequent and regular change of inner garments, is 
necessary for extraordinary, as well as ordinary pur- 
poses, to promote and sustain the healthy action of 
the skin. But considerable danger arises from the 
habit of too frequent cold bathing, whether as shower, 
plunge, or sponge baths. This habit interferes with 
the natural and healthy circulation of the blood, re- 
tards the action of the heart for the time being, and 
not unfrequently disturbs its functional office. If the 
bathing-tub is preferred to the sponge, twice a week 



45 

is sufficient in nearly all cases. The water should be 
used tepid, except for those parts of the body which 
are exposed to the atmosphere. 

Excessive mental excitement and depression should 
be studiously suppressed and prevented, as they 
lower the healthy functional action of the whole 
system, and predispose it to take . on more rea- 
dily any prevailing epidemic. In our unsystematic 
community there is no small danger from over-work, 
which, by regulating the hours and quantity of labor, 
for mind and body, may easily be prevented. The 
dissipated and the intemperate have generally become 
the first victims of cholera, with hardly a hope of re- 
covery. He who bears a depraved mind in a diseased 
body, has but a poor chance where the balance of 
power, under the most favorable circumstances, is on 
the side of the enemy. The due observance of the laws 
of Nature, which are the laws of Health, and of the 
still higher law which regulates the requirements of 
morality and conscience, answers to the strictest de- 
mands of medical science. 

Diet. This is a most important element in the 
category of preventive measures. It may safely 
be asserted that he dines best, and even most luxuri- 
ously, whose fare is the simplest and plainest, and 
whose table is weighed down by the least number of 
dishes. It is a matter of great regret that an impres- 
sion should exist in society generally, that the conse- 
quence of a family is enhanced by the plurality of the 



46 



dishes off which they make a meal. It is perhaps as 
doubtful a foundation for respectability as it is injuri- 
ous to health and dangerous to happiness. It leads to 
the bad habit of overloading the stomach with a vari- 
ety of indigestible, unwholesome and incongruous sub- 
stances from which nothing but ill health and, too of- 
ten, sudden and acute disease result. One or two 
plainly and well-cooked dishes of good meat, and as 
many of vegetables is a better dinner than the feast 
of a London Alderman, or the banquet of Sardanapa- 
lus. " Eat to live," is an old, but very good rule, and 
forbids all excesses in eating and drinking. 

On this Coast, as well as in the other States of the 
Union, there is an inordinate appetite, amounting to a 
sort of passion, for early fruit and vegetables. It is, 
indeed, very commonly expressed by the phrase, " O, 
I love them so /" I may safely assert, after many 
years 7 experience and observation, that these "beloved 
objects" are the cause of seven-eighths of all the cases 
of bowel complaints that occur in the United States 
during the season. The very large demand for them, 
and at any price, makes it an object to have them ear- 
ly in market. They are, therefore, gathered in an un- 
ripe state, brought a long distance to town, exposed in 
the hot sun till partial decomposition takes place ; they 
are purchased and eaten, and all the consequences that 
may be expected from a large mess of decayed vege- 
table matter in the human stomach is the result. In 



47 

" Cholera times," and at all other times, the best 
advice we can give is that, — 

" Some are good, and sell dearly ; while some, 'tis well known, 
" Are so dear, and so bad, they are best let alone." 

Cucumbers, radishes, cabbage, &c, &c, do good to 
none and mischief to many. 

Some of the worst cases of Cholera-morbus I have 
met with on this coast I have traced to eating fish of 
different kinds, and, perhaps, in a doubtful condition 
for the table. I do not think that too much caution 
can be exercised by those who are in the habit of eat- 
ing a hasty meal at public tables as to the character 
and quality of what they eat. On the whole, whether 
at home or abroad, perhaps the less fish, of any kind, 
people eat, during hot seasons, when bowel complaints 
mostly prevail, the better. As to pork, it is not now 
necessary to refer to it ; the people are pretty well 
cured of it already. Mince-pies, sausages, and the 
like, may be fairly tested, as to their fitness for human 
food, by placing them before any well-cared-for dog, 
and being guided by his action in the premises. To 
go into further detail here is both undesirable and un- 
necessary for my present purpose. Most persons, who 
are in the habit of exercising any caution at all, know 
what generally agrees with them ; and so long as they 
keep within these limits they have not much to fear. 

Errors, however, may arise on the other side from mo- 
tives of fear, or religious duty. It is not right 
that people should stint themselves of a full and suffi- 



48 

cient quantity of wholesome food, lest they may 
overload the stomach and disturb the function of di- 
gestion ; this is the other extreme. 

When the cholera appeared in Paris, in 1832, it 
was during the season of Lent, and it was noticed 
that the mortality was much greater than during any 
other period of the year. In Louisiana, where the 
majority of the people are Roman Catholics, four 
times as many died of cholera as in Protestant com- 
munities of the same numerical population. This has 
been attributed partially to the strict fasting and ab- 
stinence required by the rules of the Catholic Church ; 
since it is well known that insufficient and inferior 
diet reduces the system below par faster than the 
hardest labor, or even sickness. I may here remark 
that the laws of Nature are admitted by all to be 
the laws of God. Religious ordinances need not 
conflict with them ; and when they do, it is very 
clear that the penalty is always sure to be exacted to 
the full on behalf of the former. 

With regard to wines, alcoholic and fermented 
liquors, there is but little to be said. They who use 
them least are, I believe, in a better state of 
mind and body at all times, than those who use 
them in excess ; they are less liable to con- 
tract disease, and more likely to have a shorter 
sickness and a better recovery. If, however, they can 
be obtained of a good and pure quality — which admits 
of some doubt — they can be used at all times without 



49 

abuse ; and often, under certain circumstances, to great 
advantage. They are dangerous elements only in the 
hands of the weak and the foolish ; whilst the wise 
and the prudent use them for the purpose for which 
they were intended by Providence. . 

It may, perhaps, be for the good of the people gen- 
erally, if our lawmakers would remove dangerous 
weapons as far as possible out of reach of those 
who do not know how to use them. If to get drunk 
cost as much as the " concealed deadly weapon," and 
the " fine for carrying it," health and morality would 
be great gainers. It will doubtless be so, when our 
laws are framed to prevent crime rather than to li- 
cense its inducements, and then punish the culprit ! 



50 



CHAPTER V. 

WHAT TO DO IN CASES OP SUDDEN EMERGENCY. 

In dealing with this part of our subject, it is a 
matter of congratulation that in our climate, mild and 
uniform as it is, there is not that danger of sudden 
and fatal attacks with hardly a moment's forewarning, 
so common and so much dreaded in India, China, on 
the coast of Africa, and in the Southern States of the 
Union. Cholera generally gives notice of its advent 
by a group of well marked premonitory symptoms. 
By giving due and early attention to these, there is 
everything to hope and little to fear. These are las- 
situde, that is, " a weary, tired feeling of body"; de- 
pression of spirits — a kind of undefined foreshadowing 
of approaching danger or evil ; a gradual, or sudden, 
derangement of the bowels, with vomiting generally ; or 
what is known as u purging and vomiting" When 
these assume an obstinate character, or " hang on," as 
the common phrase goes, it is time to think of what 
had better be done. It will be wise to form this reso- 
lution as early as possible ; a delay of a few hours, 
" hoping that it will pass off," may have very serious 
consequences. 

But what is to be done ? — There is still a more im- 



51 

portant question — What is not to be done 1 for in these 
cases, generally, people in their haste use means that 
are most likely to hurry matters to a rapid and fatal 
termination. First, then, do not delay sending for 
your physician. If he is enlightened and experienced, 
so much the better ; but if not, and that his first 
efforts should be to dose and deplete, you had better 
trust to Nature and to Providence. Second: Do not, 
in the meantime, dose yourself with opium, laudanum, 
calomel, " pain-killer," or with any other strong drugs 
or quack nostrums. Do not drink strong doses of 
brandy or whiskey — do not, in a word, rush blindly, 
in your terror, upon certain death by swallowing a 
quantity of deadly poison to cure a disease which 
may, by the aid of Nature and good nursing, terminate 
with your recovery ! 

Now, as to what you should do 1 First : Go at once 
to bed, be made comfortably warm with sufficient cov- 
er and hot bricks or bottles of hot water to the feet, 
if cold. Lie as still as possible, do not move a limb, 
if you can avoid it, restrain the desire to go to stool 
as much as you can, and make up your mind "tJiat you 
are going to get well soon" Have hot linseed-meal 
poultices applied over the abdominal region, and fre- 
quently changed, so as to keep up heat and moisture 
as long as may be necessary. If you are thirsty, which 
is likely, drink cool water, iced water, barley water, 
toast water, rice water, or iced soda-water ; or keep 
ice in the mouth as much and long as you choose. 



52 

Have by you a few ounces of Spirits of Cam- 
phor in a well-corked bottle. On the very first inti- 
mation of trouble, take a teaspoonful of white sugar 
and add to it 12 or 15 drops of Camphor, then dissolve 
it in as many tablespoons of water, and take a 
table spoonful every 5, 10, 15 or 20 minutes as the ne- 
cessity of the case demands, till relief is obtained ; the 
first symptom of which will probably be perspiration ; 
and as improvement advances double the interval be- 
tween the doses. This very simple and convenient 
domestic method has been tested more fully than any 
other we know, and attended with the happiest re- 
sults. It is strictly Homoeopathic. If, however, the 
case should resist, which it has been seldom known to 
do, when taken in time, it becomes too critical and seri- 
ous for domestic treatment, and will require the skil- 
ful hand of a physician and the watchful care of a good 
nurse to bring it to a favorable issue. 

But in the meantime a physician may have arrived, 
— your own or somebody's, — Allopath, or Homoeo- 
path. But you must take good care, if of the 
Old School, that he is of Dr. Maclean's stamp ; one who 
will " not goad you with physic," who " will not pour 
calomel in combination with opium into you every 
hour," and destroy your only chance of recovery. If 
of the New School, see that he is not an illiterate 
quack, who is " ready to treat you either way," — a bro- 
ken-down pedlar or preacher, who goes about with a 
case of globules and a pocket-manual," — one who do- 



53 



ses an infant with " wine and iron," and an adult with 
" calomel and jalop," under the guise of Homoeopathy*! 
— or some female impostor, who talks of being "a gra- 
duate" and " having a die-ploma /"* 

During the period of convalescence or recovery, the 
greatest care must be taken not to produce a reaction 
by injudicous or careless diet. Of this there is great 
danger, as it is supposed, the patient being now so 
weak and reduced, " he must be, at once, built up." 
Almost every one knows how much care is required 
in the diet of a patient recovering from Typhoid fever ; 
the same rule holds in recovery from Cholera. 
When the acute symptoms, vomiting and purging, 
have ceased, it is well to begin with a little well 
cooked arrowroot flavored, and with a couple of tea- 
spoonsful of brandy in it ; oatmeal gruel, " thickened 
milk," etc., may be used. " Little and often " should 
be the rule here — not more than a tablespoonful at a 
time should at first be given ; but as recovery ad- 
vances, chicken-broth, mutton-broth, beef-tea, or beef- 
essence may be administered ; gradually improving 
the patient's diet till his cure is complete. Any other 
course than this may produce a relapse that will defy 
both domestic and professional means. Persons who 
are liable to " weakness of the bowels," may do well 



•-Almost daily instances of the necessity of the above caution, as it regards the 
New School, have come under the writer's notice for the last four years in this city, 
to the disgrace of a School of Medicine which has had too few faithful and compe- 
tent representatives to uphold it. But the better and more hopeful any cause, the 
gi eater is its number of parasites and hypocrites. 



54 

to wear a strong and tolerably wide belt made of linen 
or " drilling," lined with flannel round the abdomen. 
I will conclude with one important caution : When 
the first case of Cholera is reported in the city, do not 
rush into the country through fear of " taking it." 
You put yourself out of the reach of good nursing and 
efficient medical aid, if the terror that hurries you away 
should produce the disease ; no very unlikely result. 
To be certain that Cholera is contagious, remember 
that it must be shown from whom the first cases have 
been "taken"; and how, in the midst of a densely 
crowded city, it terminates by a last case, when there 
are so many in the immediate vicinity of the patient to 
" take the infection." 






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